Fri Feb 18 2022

52 articles - From Saturday Feb 12 2022 to Friday Feb 18 2022

parm_toc.knit

Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…

Am J Kidney Dis

KDOQI US Commentary on the KDIGO 2020 Clinical Practice Guideline for Diabetes Management in CKD.

Recent developments for prevention of CKD progression and cardiovascular events in people with diabetes and CKD, particularly related to sodium/glucose cotransporter 2 (SGLT2) inhibitors, have filled a longstanding gap in nephrology's approach to the care of persons with diabetes and CKD. The multifaceted benefits of SGLT2 inhibitors have facilitated interactions between nephrology, cardiology, endocrinology, and primary care, underscoring the need for innovative approaches to multidisciplinary care in these patients. We now have more interventions to slow kidney disease progression and prevent or delay kidney failure in patients with diabetes and kidney disease, but methods to streamline their implementation and overcome barriers in access to care, particularly cost, are essential to ensuring al patients may benefit.

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Clin Kidney J

Subtyping hospitalized patients with hypokalemia by machine learning consensus clustering and associated mortality risks.

Our study demonstrated the use of consensus clustering analysis in the heterogeneous cohort of hospitalized hypokalemic patients to characterize their patterns of baseline clinical and laboratory data into three clinically distinct clusters with different mortality risks.

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Meta-analysis

meta-analyses and systematic reviews


Studies

RCT, clinical trials, retrospective studies, etc…

Am J Kidney Dis

Values, Perspectives, and Experiences of Indigenous Maori Regarding Kidney Transplantation: A Qualitative Interview Study in Aotearoa/New Zealand.

Maori participants were highly motivated to seek kidney transplantation and were inspired by positive experiences through donating and receiving a kidney. However, they faced barriers including social determinants, racism, and lack of information that impacted both direct experiences of transplantation and access to transplantation services.

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Clin J Am Soc Nephrol

Relative Contributions of Pseudohypoxia and Inflammation to Peritoneal Alterations with Long-Term Peritoneal Dialysis Patients.

Reducing peritoneal exposure to the excessively high dialysate glucose load is the cornerstone to avoid the pseudohypoxia-induced alterations. This can partly be done by the use of icodextrin, or by combinations of low molecular weight osmotic agents, al in a low dose. The addition of alanyl-glutamine to the dialysis solution needs further clinical investigation.

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Seroresponse to SARS-CoV-2 Vaccines among Maintenance Dialysis Patients over 6 Months.

Among patients receiving maintenance dialysis, vaccine-induced seroresponse wanes over time across vaccine types. Early titers after full vaccination are associated with the durability of seroresponse.

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Vaccination and COVID-19 Dynamics in Dialysis Patients.

Our findings suggest that vaccination may yield a protective effect against severe forms of COVID-19 in dialysis patients, despite altered immunologic vaccine responses.

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Clin Kidney J

A functional TGFB1 polymorphism in the donor associates with long-term graft survival after kidney transplantation.

Conflicting data exist about the effect of transforming growth factor-beta 1 (TGF-ß1) on kidney transplant survival, since TGF-ß1 has pro-fibrotic and protective effects. We investigated the impact of a recently discovered functional polymorphism have a higher risk of late graft loss. Our study adds to a growing body of evidence that TGF-ß1 is beneficial, rather than harmful, for kidney transplant survival.

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Clustering phosphate and iron-related markers and prognosis in dialysis patients.

We used an unsupervised machine learning method to cluster patients, using phosphate, hemoglobin and iron-related markers. In two of the clusters, the oral use of a phosphate binder might improve prognosis.

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Contemporary outcomes of anemia in US patients with chronic kidney disease.

Anemia, frequently observed in NDD-CKD and associated with adverse clinical outcomes, is rarely treated with ESAs and intravenous iron. These data suggest that opportunities exist for improved anemia management in patients with NDD-CKD.

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Crystalline podocytopathy and tubulopathy linked to kappa light chain deposits in a context of smoldering multiple myeloma.

A 42-year-old man with smoldering immunoglobulin G kappa multiple myeloma showed a heavy proteinuria composed of free light chain, prompting performance of a kidney biopsy. Electron microscopy revealed numerous rhomboid-shaped crystals labelled by the anti-kappa in immunogold, notably in the cytoplasm of podocytes, establishing the diagnosis of crystalline podocytopathy. This case illustrates a rare form of monoclonal gammopathy of renal significance, and highlights the key role of electron microscopy and immunogold to better elucidate the location and composition of crystals.

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Development and internal validation of a Wasp Sting Severity Score to assess severity and indicate blood purification in persons with Asian wasp stings.

Patients with WSS scores =3 should be considered for blood purification as early as possible in addition to routine treatment. In addition, PE is better than CVVH and HP at reducing mortality in patients suffering from severe wasp stings.

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Early and late acute kidney injury: temporal profile in the critically ill pediatric patient.

Temporal nature and trajectory of AKI during a critical care course are significantly associated with patient outcomes, with several subtypes at higher risk for poorer outcomes. Stratification of pediatric critical care-associated AKI into distinct phenotypes is possible and may become an important prognostic tool.

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Fiber intake and health in people with chronic kidney disease.

Despite this, the majority of people with CKD consume less than the recommended dietary fiber intake, which may be due in part to the competing dietary potassium concern. Based on existing evidence, we see benefits from adopting a higher intake of fiber-rich food, and recommend cooperation with the dietitian to ensure an adequate diet plan. We also identify knowledge gaps for future research and suggest means to improve patient adherence to a high-fiber diet.

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Impact of contrast-induced acute kidney injury on long-term major adverse cardiovascular events and kidney function after percutaneous coronary intervention: insights from a territory-wide cohort study in Hong Kong.

Among patients undergoing a first-ever PCI, CI-AKI of any severity was associated with a higher adjusted risk of MACE at 5 years. Severe CI-AKI has a stronger association with MACE and its individual components, with an excess of early and late events.

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Local anesthetics for the Nephrologist.

They are also used to manage acute and chronic pain conditions, in regional nerve blockade and in multi-modal enhanced recovery protocols. Despite their frequent use by both physicians and patients, data on the use of local anesthetics in patients with kidney impairment are not well reported. This review will summarize the use of local anesthetics in chronic kidney disease, describe their pharmacology and the impact of lower estimated glomerular filtration rate on their pharmacokinetics, and suggest dose regulation in those with kidney dysfunction.

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Oxalate nephropathy: a review.

The possibility of antibiotic use predisposing to ON is discussed. Therapies for hyperoxaluria and ON are reviewed with an emphasis on newer treatments available and in development. Promising research avenues to explore in this area are discussed.

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Plasma neutrophil gelatinase-associated lipocalin and kidney graft outcome.

Independent of these, pNGAL was positively associated with urinary protein excretion, systemic inflammation parameters and calcineurin inhibitor use. During median follow-up of 5.3 (4.5-6.0) years, death-censored graft failure rates were 3.9%, 7.3% and 25.0% across increasing tertiles of pNGAL (P ClinicalTrials. gov NCT02811835.

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Podocyturia in Fabry disease: a 10-year follow-up.

Our data demonstrated that podocyturia is an early clinical event in the development of nephropathy. In addition, we found podocyturia to be a discontinuous event with wide variability.

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Prevalence, progression and implications of breast artery calcification in patients with chronic kidney disease.

Major adverse cardiovascular event-free survival was significantly worse in Tx patients with BAC. In conclusion, BAC is common among CKD patients, progresses at a slower pace in Tx patients as compared with CKD 5D and associates with dismal cardiovascular outcomes. BAC score, kidney function, serum phosphate at baseline and VKA usage seem to be important determinants of progression.

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Successful treatment of calciphylaxis with vitamin K in a patient on haemodialysis.

We report a second case of a female haemodialysis patient who developed calciphylaxis twice and was successfully treated with vitamin K supplementation on both occasions. She did not receive sodium thiosulphate or bisphosphonates nor was there a change made to her dialysis time or prescription. This case highlights how supplementation with vitamin K may improve the outcome of this condition.

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Successful treatment of refractory hypertension with bilateral nephrectomy in a patient with chronic kidney disease stage 3.

Both RDN and BLN reduce the increased sympathetic activation in rHTN. However, RDN has yet to show reductions in blood pressure adequate for the average patient with rHTN, and BLN has thus far been reserved for patients with preexisting end-stage kidney disease (ESKD). Our case suggests that there are patients with rHTN that warrant consideration of BLN prior to developing ESKD.

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The burden of subclinical cardiovascular disease in children and young adults with chronic kidney disease and on dialysis.

There is a high burden of subclinical CVD in young CKD patients, with a greater prevalence of functional abnormalities in dialysis compared with CKD patients. Longitudinal studies are required to test these hypothesis-generating data and define the trajectory of CV changes in CKD.

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Translational research in nephrology: prognosis.

It aims at estimating the risk of adverse health outcomes in individuals, conditional to their clinical and non-clinical characteristics. There are three fundamental steps in prognostic research: development studies, in which the researcher identifies predictors, assigns the weights to each predictor, and assesses the model's accuracy through calibration, discrimination and risk reclassification; validation studies, in which investigators test the model's accuracy in an independent cohort of individuals; and impact studies, in which researchers evaluate whether the use of a prognostic model by clinicians improves their decision-making and patient outcome. This article aims at clarifying how to reduce the disconnection between the promises of prognostic research and the delivery of better individual health.

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J Am Soc Nephrol

A Founder Mutation in EHD1 Presents with Tubular Proteinuria and Deafness.

Diagnostic and functional studies were performed in patients and disease models to investigate the pathophysiology. Results We identified six individuals (5-33 years) with proteinuria and a high-frequency hearing deficit associated with the homozygous missense variant c.1192C>T (p. R398W) in variants should be considered in individuals with hearing impairment, especially if tubular proteinuria is noted.

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Chimeric Fusion between Clostridium ramosum IgA Protease and IgG Fc Provides Long-lasting Clearance of IgA deposits in Mouse Models of IgA Nephropathy.

We constructed a chimeric fusion of IgA protease with Fc and demonstrated its long-lasting efficacy as a promising targeted therapy for IgA nephropathy.

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CRISPR/Cas9-Engineered HLA-Deleted Glomerular Endothelial Cells as a Tool to Predict Pathogenic Non-HLA Antibodies in Kidney Transplant Recipients.

The NHADIA identifies non-HLA Abs and strongly predicts graft endothelial injury independent of HLA-DSAs.

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IL-17 Receptor C Signaling Controls CD4+ TH17 Immune Responses and Tissue Injury in Immune-Mediated Kidney Diseases.

Background IL-17A-producing CD4 + T helper (T 17 treatment strategies.

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Risk Prediction Models for Atherosclerotic Cardiovascular Disease in Patients with Chronic Kidney Disease: The CRIC Study.

The 10-year ASCVD risk prediction models developed in patients with CKD, including novel kidney and cardiac biomarkers, performed better than equations developed for the general population using only traditional risk factors.

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Nephrol Dial Transplant

A real world comparison of HepB (Engerix-B®) and HepB-CpG (Heplisav-B®) vaccine seroprotection in patients receiving maintenance dialysis.

Seroprotection rates in Hepatitis B vaccine naïve dialysis patients administered recommended 4 doses HepB was higher than recommended 2 doses HepB-CpG. Seroprotection rates were higher and achieved sooner if HepB-CpG utilized initially and, if needed, for Series 2. Optimal HepB-CpG dosing deserves further study.

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Estimating 24-hour urinary excretion using spot urine measurements in kidney stone formers.

Although spot urine samples may hold promise for clinical and population-based research, at present they have limited utility in clinical practice. Measuring or estimating 24-hour creatinine, rather than assuming a given creatinine excretion, will be necessary in future studies of spot urine samples.

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Long-term cognitive impairments in kidney transplant recipients: impact on participation and quality of life.

This study shows long-term cognitive impairments in KTR which are not related with disease related variables. Neuropsychological assessment is important to timely signal these impairments, given their serious negative impact on societal participation and QoL.

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Neutrophil:lymphocyte ratio correlates with the uremic toxin indoxyl sulfate and predicts the risk of death in patients on hemodialysis.

In HD patients, the NLR predicted mortality and cardiovascular events but not severe infections and correlated positively with the level of the uremic toxin IS. The NLR could be an interesting marker for monitoring the risk of clinical events in CKD patients.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Am J Kidney Dis

Only Part of the Story.

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Outscoring Current Classification Systems for Nephrotic Syndrome.

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Clin J Am Soc Nephrol

Growing Understanding of the Clinical and Serologic Effects of COVID-19 Vaccines in Patients Undergoing Long-Term Dialysis.

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Clin Kidney J

Cardiovascular changes in young renal failure patients.

Among the 100 patients between 5 and 30 years of age included in the study, 84 presented with signs of cardiovascular disease. There is a need for long-term follow-up data on cardiovascular consequences of renal failure early in life and evaluation of prophylactic and therapeutic measures that can ameliorate the overall prognosis for these patients. We look forward to planned future long-term data from this cohort as well as increased focus in general on cardiovascular changes in young renal failure patients.

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J Am Soc Nephrol

Cardiovascular Risk Prediction Scores in CKD: What Are We Missing?

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Nat Rev Nephrol

Experimental models of acute kidney injury for translational research.

These organoid and AKI models are being deployed at different stages of preclinical therapeutic development. However, the traditionally siloed, preclinical investigator-driven approaches that have been used to evaluate AKI therapeutics to date rarely account for the limitations of the model systems used and have given rise to false expectations of clinical efficacy in patients with different AKI pathophysiologies. To address this problem, there is a need to develop more flexible and integrated approaches, involving teams of investigators with expertise in a range of different model systems, working closely with clinical investigators, to develop robust preclinical evidence to support more focused interventions in patients with AKI.

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Kidney and heart failure outcomes associated with SGLT2 inhibitor use.

With respect to their safety, SGLT2 inhibitors are generally well tolerated. More specifically, no increased risk of hypoglycaemia has been observed in patients with CKD or heart failure without diabetes and they do not increase the risk of acute kidney injury. SGLT2 inhibitors therefore provide clinicians with an exciting new treatment option for patients with CKD and heart failure.

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Letters&Replies

Letters to the editors and authors’ replies

J Am Soc Nephrol

Authors' Reply: SARS-CoV-2 Vaccination in Kidney Transplant Recipients: Should We Consider Intradermal Vaccination?

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SARS-CoV-2 Vaccination in Kidney Transplant Recipients: Should We Consider Intradermal Vaccination?

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Kidney Int

A fourth SARS-Cov-2 mRNA vaccine in strictly seronegative kidney transplant recipients.

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Breakthrough Omicron COVID-19 infections in patients receiving REGEN-Cov antibody combination.

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Response to "Diagnosis and Treatment of Arterial Hypertension 2021".

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Response to: "Response to "Diagnosis and Treatment of Arterial Hypertension 2021".

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Others

all remaining publications eg case reports, images of the month, etc…

Clin J Am Soc Nephrol

Breaking the Barriers to Innovation in Kidney Care.

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Clin Kidney J

Evaluation of rapid changes in haemodynamic status by Point-of-Care Ultrasound: a useful tool in cardionephrology.

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Kidney immunology: embracing the complexity to advance the field.

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J Am Soc Nephrol

Enabling Patient Choice: The "Deciding Not to Decide" Option for Older Adults Facing Dialysis Decisions.

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Kidney Int

Is HIF activation Janus-faced? The therapeutic effects of HIF-2a inhibitor.

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Role of uremic toxins in vascular disease - the end of nihilism?

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Nat Rev Nephrol

Kidneys control inter-organ homeostasis.

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